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Objective:To investigate the relationship between sarcopenia and the maximum diaphragm excursion(Dmax)observed on ultrasound in the elderly.Methods:Elderly volunteers(age≥60 years)were recruited from family members of patients at Guangdong Provincial People's Hospital.Their Dmax during forced inhalation was measured via ultrasound.The parameters for the diagnosis of sarcopenia included the appendicular skeletal muscle mass index(ASMI), handgrip strength and usual gait speed.We compared the differences in physical characteristics, pulmonary ventilation, physical performance and Dmax between patients with and without sarcopenia, and evaluated the relationship between sarcopenia and DEmax in the elderly via linear regression.Results:A total of 145 elderly volunteers[age(69.47±5.15)years]were included, and 28(19.31%)were diagnosed with sarcopenia.Body weight, ASMI, maximum inspiratory pressure(Pinmax), maximal power output(Wmax)and Dmax of patients with sarcopenia were significantly lower than those of patients without sarcopenia(all P<0.05).Dmax in the elderly was correlated with sex, height, ASMI, handgrip strength, usual gait speed, Pinmax and Wmax( r=0.181, 0.130, 0.322, 0.373, 0.401, 0.134, and 0.388, P=0.012, 0.037, 0.009, 0.002, 0.022, 0.009, and 0.002, respectively).After adjusting for sex, age, height and forced vital capacity(FVC), there was still a negative correlation between sarcopenia and Dmax in the elderly( β=-0.310, P=0.021). Conclusions:Dmax is related to Pinmax and physical performance in the elderly, and sarcopenia increases the risk of decline in the maximum diaphragm excursion in the elderly as observed on ultrasound.
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Objective:To investigate the correlation between the muscle mass loss and severe postoperative pulmonary complications(PPC)in elderly patients with non-small cell lung cancer(NSCLC).Methods:Elderly patients with NSCLC undergoing lobectomy at the Lung Cancer Institute and the Department of Thoracic Surgery of Guangdong Provincial People's Hospital were recruited from Feb.2019 to Dec.2019.Data of the body composition, lung function, respiratory muscle strength test, cardiopulmonary exercise test were collected before operation.All patients were grouped into two groups: with versus without severe PPC at 30 d after operation.The differences of the above parameters were compared between the two groups.A multiple logistic regression analysis was used to analyze the risk factors for severe PPC.Results:In this study, 120 elderly NSCLC patients undergoing lobectomy were recruited, All evaluations were completed in 113 patients(aged 68.13±7.01 years)in whom, 21(18.58%, 21/113)patients had serious PPC.Compared with patients without PPC, patients with severe PPC had a lower appendicular skeletal muscle mass index(ASMI)(5.67±0.90 kg/m 2vs.7.71±1.40 kg/m 2, t=3.900, P=0.001), a lower forced expiratory volume in 1 second(FEV 1)(1.85±0.40 L vs.2.12±0.57 L, t=2.412, P=0.027), a lower maximal mid-expiratory flow(MMF)(1.40±0.69 L/s vs.2.11±1.09 L/s, t=2.502, P=0.021), a lower maximum inspiratory pressure(Pimax)(55.13±32.52 cmH 2O vs.64.71±20.60, t=0.778, P=0.047, 1 cmH 2O=0.098 kPa), a lower maximal oxygen consumption(Vo 2max)(1.14±0.41 L/min vs.1.40±0.34 L/min, t=0.779, P=0.046), a lower peak O 2 consumption(Vo 2max@kg)(20.00±1.91 L·min -1·kg -1vs.22.33±2.37 L·min -1·kg -1, t=0.813, P=0.041). Multiple logistic regression analysis showed that in addition to FEV 1( OR=2.824, 95% CI: 1.127-5.158, P=0.001)and Vo 2max@kg( OR=3.149, 95%CI: 1.829-6.592, P<0.001), ASMI was also an independent risk factor for serious PPC( OR=1.919, 95% CI: 1.604-3.466, P=0.006), in which the best cut-off value was 6.295 kg/m 2, the sensitivity and specificity were 0.816 and 0.818 respectively, and the area under the receiver operating characteristic(ROC)curve(AUC)was 0.887(95% CI: 0.793-0.981, P<0.0001). Conclusions:Muscle mass loss can increase the risk for the occurrence of severe PPC within 30 days after lobectomy in elderly patients with NSCLC.
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Objective To study the effect of electrical stimulation breath training on lung function of patients following pulmonary lobectomy. Methods 62 patients following pulmonary lobectomy were randomly allocated into experimental group (n=30 )and control group (n=32). The experimental group received a 4-week supervised electrical stimulation breath training program using an electric stimulus feedback trainer (20mins per time, 3 times per week);The control group received postoperative routine nursing. Cadiopulmonary function evaluation of 2 groups were tested before and after the experiment. The evaluation included the 6-min walking test (6MWD), FVC, FEV1,W,AT and VO2max/kg. Results After 4 week training, the value of 6MWD,W,FVC,FEV1 all improved, compared to the baseline value (P < 0.05) and the value of 6MWD,W,FVC,FEV1 were more obvious in experimental group, compared to control group(P<0.05). The AT value and the VO2max/kg value increased than the baseline value (P<0.05)and the improvement degree was more remarkable in experimental group than that in control group (P<0.05). Conclusion Electrical stimulation breath training can improve cardiopulmonary function of the patients following pulmonary lobectomy.